Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutHOMESTEAD HILLS BLK 2 LT 6Homestead
Hills
Block 2
Lot 6
#015-173-21
<` MUNICIPALITY OF ANCHORAGE
w
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR
WELL INSPECTION REPORT
NAME
PHONE
❑ NEW
-1 Sa brlr Cnll,5Trd 6iY ji
UPGRADE
MAILING ADDRESS
�}
LEGAL DESCRIPTION/ f
.1
Wl ! " I Al//'As,
SZ �. R
LOCATION
N0. OF BEDROOMS
DISTANCE TO:
Well
Absorption area
�c�f
Dwelling
�t
PERMIT NO.
8 D2� 2
—Y
I_
F
Manufacturer /t Greer
Material5�
No. of compartments /
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
6�Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
O <
Manufacturer
Material
Liquid capacity in gallons
LU
DISTANCE TO:
Well/
�
Foundation
Nearest lot line
PERMIT NO.
F LL Z
Zw
No. of lines
Len th of each line
Total lenX of lines
Trench width
Distance between lines
4-5gth
"
inches
cc:f
Top of tile to finish grade
Material beneath tile
1
Total effect ve absorption area
o
3
7z inches
1Z5 M,
Length
Width
Depth
PERMIT NO.
w
Qa H
LU
Type of crib
Crib dia t r
Crib depth
Total effective absorption area
LU
m
DISTANCE TO:
Well r I
Building foundation
Nearest lot line
Ct1MWjj
Depth
Driller
Distance to lot line
PERMIT NO.
—+
0
w
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areas)
OTHER
P D r'i li 7 6
A
-
PIPE MATERIALS
T o ? l . 2-q rZ7
S01 L TEST RATI NG
275 a' a2R
\
INSTALLER
6 01
15ay L'0msf MC41Or\
REMARKS
M06" -
Ex
//qyy
GF ai t
`
r6 13 iJ /Corwin :° v
N6 C`E
\
NA
�
ji O
iiaG�''a`�'�
bu: /' ` /'(/
j
_A)AN
A
PI
i
APPROVED
DATE LEGAL
j �'•%,
�/"// /`fI �� .- 1 r/ /n t7,7
i.M�S fin // A';/S S22 7 /ZA/ K�bl�
A
Municipality
of
Anchorage
1, 1985
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Laura A. Seeley
Corwin and Associates
1549 East Tudor Road, Suite 204
Anchorage, Alaska 99507
Subject: Lot 6 Block 2 HomesteadHills' Subdivision
Lot 27 Block 2 Paradise Valley Subdivision
We received the as-builts for the above referenced properties, however,
the applicant only delivered the yellow copy of the as-builts. He
said the white original was blown away.
Please submit new original as-builts or a recertified(original stamp
and signature) copy.
Thank you. If there are any questions, please call me at 264-4720.
Sincerely,
Laura J. Ward
Acting Engineering Tech II
LJW
cc: to file
PERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
850232
05/28/85
ISABELLE CONST,
P.O. BOX 00067
AN�HORAGE� AK 99510
243�5845
�
LEGAL DESCRIP: �UBDIVISION: HOMESTEAD HILLS LOT: 6 BLOCK: 2
GECTION: 22 TOWNSHIP: 12N RANGE� 3W
LOT SIZE: 43560 (SQ"FT, OR ACRES)
MAX 4.1
Listed below are the options available tc` you if desig�ing yourseptic
system, Choose the option that b�st �its your site, .
... ..... ... ..... .....
-_~__����~_~�__�_^~�~~'��~
if w. ������ ��= ������][P�
DEPTH TO PIPE BOTTOM (FT") 3,0 ** � 3,0 ** 3,0 **
GRAVELDEPTH
TOTAL DEpTH (FT.) 9"0
GRAyEL WIDTH If ' 2"5
GRAVEL LENGTH (FT.) 92.O ** 54,0 119.0 **
GRAVEL VOLUME <rU,YDS,� 55`4 54`0 88"2
`�75 242 275
** DEPTH TO PIPE BOTTOM < 3.5 FT. REQUIRES INSULATION
** DEPTH TO PIPE BOTTOM < 4,O FT, MAY REQUIRE A LIFT STATION
** GRAVEL LENGTH > 75 FT, REQUIRES MULTIPLE IAjNS (NOT EXCEE^ING 75FT. ,ACH)
`** TANK MUST H�VE AT LEAST TWO COMP�RTMENTS
�-~~..... ... ��_��.~~_���_~..
I
I. A. at:
1" I am {amiliar with the require�ents �or m: -site .;:I and wellsas set
�orth by the Municipality o� Anchorage (MOA) and the State o[ Alaska� ^
2. Ii*ill install the system in accordance with al, MOA codes and regulations'
and in compliance with the design criteria oI this p�rmit.
3" I will adhere to all MOA andState o� Alaska requirements {or t�e se� back
distances yrom �ny existing wellr wastewatec disposal system or public
sewerage syste� on this or a:y �djacen� or nearby lot.
4, I understand that this �er�it is valid [or a maximum o� 4 bedrooms an�
an, ddit.onal permit, �
IF A LIFT STATION IS INSTALLED IN AN AREA CO»ERED BY MOA B�ILDING CODES�
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE
ELECTRICAL WORK MUST BE DONE BYA LICENSED ELECTRICIAN.
SIGNED
_... ..... ^~_... ..... �~
APPLICANT� ISABELLE CONST. / ' y
.
n
�,
^
����������
���������
DEPARTMENT
OF HEALTH
AND ENVIRONMENTAL
P�OTECTION
825
L STREET�
ANCHORAGE;
AK
995O'1
264~4720
'
^
' ���������
������
�������
PERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
850232
05/28/85
ISABELLE CONST,
P.O. BOX 00067
AN�HORAGE� AK 99510
243�5845
�
LEGAL DESCRIP: �UBDIVISION: HOMESTEAD HILLS LOT: 6 BLOCK: 2
GECTION: 22 TOWNSHIP: 12N RANGE� 3W
LOT SIZE: 43560 (SQ"FT, OR ACRES)
MAX 4.1
Listed below are the options available tc` you if desig�ing yourseptic
system, Choose the option that b�st �its your site, .
... ..... ... ..... .....
-_~__����~_~�__�_^~�~~'��~
if w. ������ ��= ������][P�
DEPTH TO PIPE BOTTOM (FT") 3,0 ** � 3,0 ** 3,0 **
GRAVELDEPTH
TOTAL DEpTH (FT.) 9"0
GRAyEL WIDTH If ' 2"5
GRAVEL LENGTH (FT.) 92.O ** 54,0 119.0 **
GRAVEL VOLUME <rU,YDS,� 55`4 54`0 88"2
`�75 242 275
** DEPTH TO PIPE BOTTOM < 3.5 FT. REQUIRES INSULATION
** DEPTH TO PIPE BOTTOM < 4,O FT, MAY REQUIRE A LIFT STATION
** GRAVEL LENGTH > 75 FT, REQUIRES MULTIPLE IAjNS (NOT EXCEE^ING 75FT. ,ACH)
`** TANK MUST H�VE AT LEAST TWO COMP�RTMENTS
�-~~..... ... ��_��.~~_���_~..
I
I. A. at:
1" I am {amiliar with the require�ents �or m: -site .;:I and wellsas set
�orth by the Municipality o� Anchorage (MOA) and the State o[ Alaska� ^
2. Ii*ill install the system in accordance with al, MOA codes and regulations'
and in compliance with the design criteria oI this p�rmit.
3" I will adhere to all MOA andState o� Alaska requirements {or t�e se� back
distances yrom �ny existing wellr wastewatec disposal system or public
sewerage syste� on this or a:y �djacen� or nearby lot.
4, I understand that this �er�it is valid [or a maximum o� 4 bedrooms an�
an, ddit.onal permit, �
IF A LIFT STATION IS INSTALLED IN AN AREA CO»ERED BY MOA B�ILDING CODES�
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE
ELECTRICAL WORK MUST BE DONE BYA LICENSED ELECTRICIAN.
SIGNED
_... ..... ^~_... ..... �~
APPLICANT� ISABELLE CONST. / ' y
.
n
t
i
9�-' SOILS LOG
•p.
MUNICIPALITY OF ANCHORAGE
9�-PERCOLATION
r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
I� /! 825 L. Street, Anchorage, Alaska 99501 264.4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: �e`(c 060-Ic4y4'4.1. (.e('1 DATE PERFORMED:
LEGAL DESCRIPTION: LO� / `��� Ftnaf�lrL?!l' Ir�fl -� //e+�/({k35-Sfr .%2
SLOPE SITE PLAN -T
r -TT -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMM
01�6"vfc AIA 7-
s&TY sA/W/ Ir / A611FL
d
rrJ�Cp w((of
�-1ed ar X39 d�rC
i
WAS GROUND WATER S
ENCOUNTERED? tA0 L
C
P
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
.Drop
a:4�
c�sl
10
0.37
a).i�
Nab
a:s�
a. So
3:0�
lC
o,�3
D.o7
b.�
+QY,o
a: 2
l0
0.5b
0- �
44
O 61
O.yY
0,06
PERCOLATION RATE t[� % $ (minutes/inch)
r TEST RUN BETWEEN /'S FT AND S� FT
.1ev -�ro '
� a � /3
PERFORMED BY: LlontH+f 61' GNOo -'345 a5� CERTfFIED BY:
J
79.nnn ran4i
_ DATE: s S
GREATER ANCHORAGE AREA BOr--.,UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
-y- INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME /x'11-3TCU-HiE?r` MAILING ADDRESS 910Z /7/k' PHONE -3
LOCATION TR4)f'1-/RJe IM)h�))T 40(5 1916il?&-kkEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE i NUMBER OF
FROM WELLt1 ; MANUFACTURER heR —MATERIAf'� ��(� ) Irl ��COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY-' GALLONS.
SEEPAGE PIT:
�g '3, 1 i }
NUMBER OF PITS f DIAMETER --OR WIDTH �')LENGTH� DEPTH 42
LINING MATERIAL /x CRIB SIZE: DIAMETERf' f DEPTH f I DISTANCE FROM: WELL �. ee)
pI % TOTAL EFFECTIVE
BUILDING FOUNDATION IL NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT.
ADDITIONAL ABSORPTION
WELL: e Z L✓lt
TYPE
CONSTRUCTION CONSTRUCTION_117 ,�,ecl DEPTH
BUILDING NEAREST
FOUNDATION—,LOT LINE
CESSPOOL OTHERSOURCES
APPROVED DISAPPROVED
DISTANCES: `'1,1
INSTALLED BY: A'��.9r
PIPE MATERIAL: _i!Lj�ja'Pa%til
LOT SLOPE::q��
REMARKS: -%JPyjpij�_ n&r Ve.T riRiw-
16
A
�4(hv/ 02 cpe- 'ft-ttivI—In V, K..
NEAREST SEPTIC
SEWER LINE—,TANK _
REMA
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM _
r
C
0
e
`,
r,
N t
i � c
4f
pi
N
1
+
V{ r}
DATE aZ J APPROVED v ✓—(r f' a . Ce', h
G.A.A.B.
/"i
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
PERMIT NO.
NAME OF APPLICANT
/�'� , 3 P e-44✓7` A. MAILING ADDRESS
INSTALLATION LOCATION / %^ % /s�
LEGAL DESCRIPTION %� d%/ ({- /?/ ' J � �✓ ✓� ! / ��`"�
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
SEEPAGE PIT DRAIN FIELD
OL
OTHER ,
FINANCED THROUGH TO BE INSTALLED BY
so1L TEST RESULTS /) R�' NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED [ J
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE 4'e �� TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
r /
FOUNDATION TO SEEPAGE PIT a�
� DRAIN FIELD
SEEPAGE AREA SIZE
SEPTIC TANK TO SEEPAGE PIT WALL /-a
SEPTIC TANK �, SEEPAGE PIT �, DRAIN FIELD
TO NEAREST LOT LINE.
f n i
WELL TO SEPTIC TANK j ��/' SEEPAGE PIT ��aa ,
DRAIN FIELD `J ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK L SEEPAGE PIT
DRAIN FIELD_lt2 f
{ i
SEPTIC TANK, SEEPAGE PIT �""('DRAIN FIELD.
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G .A.A .B.
OR
LICENSED DESIGNER
I/
DIAGRAM OF SYSTEM
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A HORAGE AREA BOROUGH &OINANCE NO28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE. q /� ��gppLICANT'S SIGNATU RF_ 7 ._(,_>"�" O
CREATER AINCK,1964CE AREA le -'B
HEALTH DEPA�TMENI '
0 327 LA%"!,F `,I'Rr",'CT,
ANCMCMC-ra ALAFKA 9950
Perforftd fear Tom Stewart Date PerP)rmP(, 2 Jul
Legal DescriprMOM*_ �b Homestead Hi=l
This rcrm Reports a: S=01�g Loore�
7 r(=.1Mf7n s-,_
Soil Charlacteriztica
The sediments were com-
pact with a low to mod-
erate water content.
,The contact between the
Gm and Gm to Gw was
erratic with respect to
depth.
Was Ground Water Encountered? No
If Yes,, At What Depth
Propoz.edIrustaall Sweepage Pit Drain
::4
Dene}, Of lnlatj
. ft be 4�hTo
COMMENTS: Two feet 'M. M4- i if r__.P4.
Test Performed by. Percco
bst'*' Certified -71
Location Sketch
Municipality of Anchorage
• 4 Development Services Department
Building Safety Division x �_
On -Site Water and Wastewater Program ^'
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak. us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-173-21 HAA # 0(1 - 631
' Expiration Date:
1 GENERAL INFORMATION
Complete legal description _ Lot 6 Block 2; Homestead Hills Subdivision
Location (site address qr directions) 11331 BearRaw St. An borage. AK
Current Property own,Er(s) Jason Boesl Day phone 632-8684
.,Mailing address 10109 Baffin St. Eagle River, AK 99577
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
Day phone
Unless otherwise requested, HAA will be held by DSD for pickup. —14,4l 214211— 7 /ry/o ,/
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑
Individual Water Storage ❑
Community Class A Well [
Public Water System ❑
Individual On-site Ek
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid'for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm S & S Engineering Phone 694-2979
Address 17034.N. Eagle River Loop Ste. 204 Eagle.River, AK 99577
Engineer's Printed Name Robert C. Cowan Date 7 Wo y
5. DSD SIGNATURE
Approved for
Disapproved.
4 bedrooms.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By. /%� _ / zz�j Original Certificate Date: 702 " 0
(Rev. 01/02)
municipanty Of Andiorage
Developmeht$6 m"'e" 6f,
Building e y iy!sign
& astewater P - rogr6m'
uth rag S
. ... ......
AK
mc orage.ak.'u-s'
sc i n:: 7' 4 Aid Milt
Well Log (Y/')'
iDee ed (Y/N)
ground) _in.
,uc r9n 9-131M g.p,m�
WN 2, R-�� "Mej"RA
colonies/100 ml. Nitrate' mg./I. Other bacteria
—polonies/1100'firil.
mg./I. Date of sample: Collected by:
T "77
"J,
I -
Z ft
Date'instailled /0 /7 Ad 0 -3 -
Na ED WWI I ,
iA Cleanouts (9/N)
O"gal. Number of Compartments
AL I,
. . . . . . . . . .
n c eanout N) Y1U Depression ;�er tank High water alai
MUM
I �777, 7-77 -7-
imping Y Pumner A 4'
'06. "em" -Rm�l
7777777 Z
ISM W
W, Xd
861'l rating (d. p:'d./ft' or ft =/bdrm System type cy 16-J
Gravel below pipe ft.
ft - 2 Monitoring tube Depression over field 0
s Wail) 5 Forj--bedrooms
Its Pam,
AR
----- gal. New depthY r in.
.WV - -- '*4�, 411.-�, 11 �� 'I,
.......... 7 in --A
off level at in. � HJI � � ` � a arm level at in.
tested Meets alarm& circuit requirements?
Public sewer manhole/cleanout
Holding tank
JM *SEPT'VIHOODING TANk�*'ON'LO7 T0>"
Property line s + Absorption field f
Water service line )d Surface water /00 4
.. "
t
'4 Q.,.6 -S 76,0
4-
+
ieLermined tIIou"gli fieRUinspectrons and
records that the above systems are in
fOA HAA/guidelines in effect on this date. AFS xo
6 e /i 0/34,✓t7-
C 0 wi4� ✓ f+�r.�
!O
g 1 �S
npnt
J 4
7-14-04;12:28PM;REMAX PROPERTIES
;907 2764429 * 2/ 2
1 hereby certifythat I have surveyed the following described property, Lot? Block .rqE OF .4�
AlESTE'A!J H/L S 5*1/f02, Anchorage recording Precinct, Alaska, and_Ihat Qa••"••••ati'4.
the Improvements situated thereon are within the property lines and do not overlapor (7 ••• •e �9,,�
encroach on the property lying adiacent thereto, that no improvements on property /* f •,
lying adjacent thereto encroach on the premises in question and that there are no roadways, r s L
49 •t x
r.•• eeq•Newn•»•pNw• ...
transmission lines or other visible easements on said property except as indicated hereon. /.
- �I ��z Mildonea � mac$
No. 13084Anchorage, Alaska 3/ A�, /97�_ `� ui'",➢ es ••�
h'ECERT/F/E P 7 JUDY 20e4 J. d. �% `onej•••».••••'NN 1
h 0FESStONP%-%)--
— — — — — — — — /o' dr/L. 5'Wr
te
.. j
9'B i : i N' � �•1 I t
�1
/
.' Na4sE1P I 571ANb F/pe's
'7`,kNK
\
bve2
....
1 hereby certifythat I have surveyed the following described property, Lot? Block .rqE OF .4�
AlESTE'A!J H/L S 5*1/f02, Anchorage recording Precinct, Alaska, and_Ihat Qa••"••••ati'4.
the Improvements situated thereon are within the property lines and do not overlapor (7 ••• •e �9,,�
encroach on the property lying adiacent thereto, that no improvements on property /* f •,
lying adjacent thereto encroach on the premises in question and that there are no roadways, r s L
49 •t x
r.•• eeq•Newn•»•pNw• ...
transmission lines or other visible easements on said property except as indicated hereon. /.
- �I ��z Mildonea � mac$
No. 13084Anchorage, Alaska 3/ A�, /97�_ `� ui'",➢ es ••�
h'ECERT/F/E P 7 JUDY 20e4 J. d. �% `onej•••».••••'NN 1
h 0FESStONP%-%)--
Municipality of Anchoracye
\V P.O. Box 196650 • Anchorage Mask, 99519-6650 •'relephone (907)343-8301 • F',,'(()'07)34,3-82()0
4700 Braga", Street • Anchorage, Alaska 99507
Mayor Mark Begich unew.muni.org
Building Safety Division
15 Jul 04
S & S Engineering
17034 N. Eagle River Loop
Suite 204
Eagle River, AK 99577
Subject: Waiver Request for Homestead Hills Block 2 Lot 06
Waiver Request #WR040046
Parcel ID 4015-173-21
Dear Mr. Cowan:
Your request for a waiver of the required 10 feet from the Absorption Field to the
Property Line is approved. The approved separation distance is 7 feet.
This waiver approval applies to the existing Absorption Field to Property Line
separations only. Any future upgrade to the on-site wastewater disposal system will
require all separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Jeff Poet
Engineering Tech
On -Site Water & Wastewater Program
Community, Security, Prosperity
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES. i
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # LL - nl -a
1. GENERAL INFORMATION
HAA #.. kA LO\lL ESS
Complete legal description 2. h}tn,.nes%ece 14,/ll slb
Location (site address or directions) 113,31
ecrr cc w S t
Property owner 1.ou (S2 Pe f-ermu/►n
Day phone 3 y6- 2 y Z3
Mailing address 1(331 (jarnoc..., SA
Ajc 995-/6"-t5ty
Lending agency _N..4
Day phone
Mailing address
Agent _Ctiuc Ic Nor4o - Ei r"12Son Re,=t E
Fife Day phone 3q5-- /0'Z0
Address
Unless otherwise requested, HAA will be held for pickup. *62
02
2. NUMBER OF BEDROOMS:
A
3. TYPE OF WATER SUPPLY:
Individual well
Community well ✓
�G� `9� ��s�cF
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm F(uf'fbn Tcchn-Ic«( S "cl Phone 34Y.5--1:3515-
Address
ys-f3515-
Address IyS30 Ectio Sf. ,9-rcA&rczrgp, 46c 995'16
Engineer's signature �'� fi t_ Date S/(7 /96S
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
By:
H"
bedrooms, with the following stipulations:
Date 6 " 7 - 2�
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(R".1/91) BACK MOA a21
r
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVIC-E C
Environmental Services Division
EIVED
825"L" Street, Room 502 • Anchorage, Alaska 995010 (907) 343-4744
MAY 2 0 1996
Municipality of Anchorage
Health Authority Approval Checklist Dept. Health & Human Services
Legal Description: 13/k?
h6mesFiad /oil tr Parcel I.D.:
—�
A. WELL DATA
Well type Cg.Cr 4 If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Date completed
Cased to
FROM WELL LOG
Nitrate
Casing height (above ground)
Wires properly protected (Y/N)
g.p.m.
Collected by:
AT INSPECTION
Other bacteria
g.p.m.
B. SEPTIC/HOLDING TANK DATA
6/6/10s y Y
Date installed t D 13 /7 H Tank size /G� Number of Compartments t Cleanouts (Y/N) Y
Foundation cleanout (Y/1) y Depression (Y/N) N High water alarm (Y/N) N • A .
Date of Pumping f / 2-1 / 9S Pumper R a /o Roah r
C. ABSORPTION FIELD DATA
Date installed 6 Soil rating (g.p.d./ftz or 112/bdrm) 2 Z5 System type 7-rencA Cr
Length _ I p Width 3 Gravel thickness below pipe 6 Total depth 91
Effective absorption area 13 0,Y Monitoring Tube present(Y/M Y Depression over field (Y/N) N
Date of adequacy test 5-/ / `/ / 9 6 Resuly(Pass/Fail) pass For 1-/ bedrooms
17 on Nw W wx #n NW
#h N 17 7/y )nN
Fluid depth in absorption field before test (in.); vin M E Immediately after6�/gal. water added (in.): a 0
17 to NW
,N'/8 007N t 89 Abso tionrate = 6Gp d.
Fluid depth a i� Ale (ins.) Minutes later: rp ' g.p.
Peroxide treatment (past 12 months) (Y/1) Alolie (zr c w,7 If yes, give date
D. LIFT STATION N on e
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at* "Pump off' level at*
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer /septic service line
On adjacent lots —
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10 F from c. G, Property line Ko Absorption field 2s–
>
S> 'ZGC! 10 cc. rh nr
Water main/service line %:e 10 Surface water/drainage *> I 0o' Wells on adjacent lots :Z t 0o' ly la -v f
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 21 Property Line 12 Water main/service line 10 '
Surface water > 10 0 Driveway, parking/vehicle storage area
> ZOO' AP Cc�nrw+
Curtain drain None SeOn Wells on adjacent lots > 14 0' fv
F. ENGINEER'S CERTIFICATION �»
f.
I certify that have determined thru field inspections and review of Municipal records' thatxhe bbveysterrt3; re
A
in conformance with MOA HAA guidelines in effect on this date. Py
Signature J✓^� J' %%1e�-e+ c > 4 , a • • a r . » .. o
4s - •e•i •• • 60 �bn e�p
Engineer's Name %`►taoPav� F. /`tc>cr� , .Ag - e01�a;, ere 2,
V V✓
Date MO -4 17
HAA Fee $
Date of Payment
Receipt Number —Z to tP O
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
M
!Ply 577-D 1-/k"i
1 �l:�c�nr✓(
bN
5. LEGAL DESCRIPTION
MUNICIPALITY OF ANCHORAGE \�
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
•
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. In omplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPER OWNER
G" 6o il/ D 5E` ff A�
PHO
8/�6
MAILING DRESS 46-4-A J" �i l�V '�7 rT /� �U /V C/'7 Q�
PROPER RESIDENT (If different from above) PH E
2. BUYER
PH E
1L
7. WATER SUPPLY
ED INDIVIDUAL*
MAI LING ADDWS�
&-' U �✓ %� f✓
HON3. LENDING INSTITUTI N E
since June 1975. For wells drilled prior to that date, give well
MAILING ADDRESS
PHONE
4.. REAL R/AGENT .HSd �� �L ✓ v �� 9
'
MAILING ADDRESS V ✓ 9 1 TGSS
bN
5. LEGAL DESCRIPTION
'+' �/ +J�Cf G�
STREET LOCATION ���
� � �✓ /
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
❑ ❑ Four ❑ Other
�j
One
SSU SINGLE FAMILY
❑ Two ❑ Five
/❑ MULTIPLE FAMILY
09::/ Three ❑ Six
7. WATER SUPPLY
ED INDIVIDUAL*
*ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
'7 7J
�J INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date
If system is over two (2) years old an adequac test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78) n
'may/-j)�a•,,.,,�-
1._-
THIS SIDE FOR OFFICIAL USE ONLY
-
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
OM.Xt (C(-7
INSTALLER
❑Septic Tan or ❑Holding Tank
Size: O� If Tank is homemade.
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFA TURER
TOTAL ABSORPTION AREA
(D W
MATERIAL , f�
Y,
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
APPROVED FOR BEDROOMS
❑�DITIONAL APPROVAL (letter must accompany certificate)
DISAPPROVED
rZ
DATE —.—
BY (Title)
LEGAL DESCRIPTION C1
2-0 1U kNev. Biro)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received .3-- L
Time of Inspection,d 3 v
Date of Inspection 4/--/0—/57
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
c, FOR
1. Approval requested by:
Mailing Address:
Phone: .9 2'7-
2.
7-
2. Property Owner: ��j� �,� �r,�, Phone:
Mailing Address:
3. Legal Description:
4. Location: zj,/,/ '/,I
d
5. Type of facility to be inspected No. of bedrooms
6. Well Data:. (_� �a. O� �m l e� , c e�
A. Type
C. Construction D. Bacterial Analysis
B. Installer
C. Septic Tank: 1. Size 11,900 2. Manufacturer
D. Seepage Pit: 1. Absorption rea ��a 47' 2. Material
E. Disposal Field: Total length of lines
I
B. Depth
7. Sewage Disposal System:
A. Installed /o— -3— -741-
8. Distances:
A. Well to: Septic tank �,r®�� , Absorption area Sewer Lines ,
Nearest lot line , Other contamination
B. Foundation to septic tank /6 / , Absorption area 1�'�f
C. Absorption area to nearest lot line 'A ©��
Fn-nla i1/74i Dann 1 of +wn nnnnc
GREATER ANCHORAGE AREA BOROUGH.._.
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: C14RO VA FHA CONV
2. Property Owner:
Mailing Address: Day Phone.
3. Name of Buyer:�`}�//—
jl-v7
Mailing Address: �nC� AV 7350 Day Phone
4. Name of Lending Institution: /( /?iG(j 11 /
Mailing Address: Phone
5. Name of Realtor or.Agent: 10"u�✓z5'
Mailing Address: Phone 2_.77
6. Legal Description: )— <<= r � //�` /+)ee 'i i=/I"j
Location: f/4A)i�s
7. Type of Facility to be inspected: No. Bdrms. Z_
8. Water Supply
Type of Supply: ire' -Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility _
If Individual, date of installation
EO -037 11/74)
Individual (on-site) c
Page 2 of two pages - Re(' --"'S For Approval of Individual "� Water Facilities
Legal
,Description _ ? «�'' { ,. 2, t V-4
Comments
Approved
f Disapproved Date
Appro 1,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ -034 (1/74)
)XO -Z4 /I
a_,4